In potentially good news for women on hormonal birth control, a February 2018 study published in the journal Contraception found depression was not linked to progestin-only methods of contraception.
Brett Worly, MD, lead author and assistant professor of obstetrics and gynecology at The Ohio State University Wexner Medical Center, admitted that he wasn’t entirely surprised by these findings. “There have been these waves suggesting that these methods of contraception cause depression, sometimes suggesting they don’t, and it’s been a little challenging as a practicing OBGYN to truly get a sense of where the body of evidence is taking us,” he says. “And so this study really kind of summed all of that up.”
The investigative team analyzed thousands of studies—ultimately narrowing it down to 26—examining the potential mental health effects of taking hormonal birth control. The types of contraception evaluated included progestin-only injections, implants, IUDs and pills. And even among postpartum women, adolescents and women with a history of depression—three groups at a higher risk of depression—researchers concluded there was “insufficient evidence” to show a direct correlation between mood and birth control.
“It means that we used a close lens looking at the best evidence over the past 30 years to see if progestin-only methods of contraception cause depression,” explains Dr. Worly. “And basically we found that progestin-only methods of contraception, in general, don’t cause depression.”
The depression debate
In years past, anecdotal reports and some research have connected birth control to depression. A previous study published in a 2016 issue of JAMA Psychiatry suggested that depression was a “potential adverse effect” from using any kind of hormonal contraceptive, especially among adolescents. Results of other studies examining combined estrogen-progestin birth control and mood changes have been inconsistent or inconclusive.
“For women, in general, there is a substantial risk of depression at some point in their life,” he continues. “The numbers are staggering—about 10 to 20 percent of women will have some depression trouble. Most people don’t really talk about that and most people don’t even recognize it.”
And this statistic is the reason for the gray area, says Worly. “This can get confusing because sometimes people get depression while they’re on progestin-only contraception, but that doesn’t always mean that the progestin-only contraception caused the depression,” he adds. Sometimes, the condition is triggered or affected by other events or circumstances.
How you're affected
Approximately 37 million women in the United States are currently using birth control, according to the study. While Worly hopes his research will help these women feel more comfortable choosing birth control that best suits their needs, he also says the discussion is far from over.
“We summed up the information over the past 30 years as best as possible, but at some point in the future, there could be additional information—hopefully better studies, randomized control trials—and there could be a different answer,” he says.
Above all, he encourages all females to have an open dialogue with their physician. “Every woman is different and it’s important that they have a good relationship with one of their healthcare providers that they can talk to about their concerns,” he concludes. “It’s important to listen to women, to listen to their experiences and to respect their experiences.”
